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For instructor materials including Power Points, Answers to Clinical Encounter Questions, please contact userservices@mhprofessional.com.
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Content Update
December 21, 2023
Reacting to the Rise of Respiratory Syncytial Virus: An Update on Prevention: In 2023, the U.S. Food and Drug Administration (FDA) approved several prophylactic measures against the respiratory syncytial virus (RSV): 1) Nirsevimab (Beyfortus®) for the pediatric population; 2) a recombinant, adjuvanted RSVPreF3 vaccine (Arexvy®) for the geriatric population; and 3) a bivalent RSVpreF vaccine (Abrysvo®) for the pregnant and geriatric populations. Compared to palivizumab, the previous standard of care, nirsevimab has an extended half-life and convenient single-dosing schedule. Abrysvo® and Arexvy® are recommended by the Centers for Disease Control and Prevention (CDC) as single dose RSV vaccine options for adults 60 and older with shared decision making. Additionally, Abrysvo® is recommended in pregnant women at 32-36 weeks gestational age. Adverse effects (AEs) were mostly minor, although neurological AEs (e.g. Guillain-Barre syndrome) were noted in a small number of patients.
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Content Update
September 29, 2022
Approval of the Combination Nirmatrelvir/Ritonavir (Paxlovid™) for the Treatment of COVID-19 in the Outpatient Setting: In December 2021, the treatment combination nirmatrelvir/ritonavir (Paxlovid™) received emergency use authorization (EUA) by the U.S. Food and Drug Administration (FDA) for the treatment of COVID-19 in adults and children over 12 years of age. The combination pill consists of nirmatrelvir, a 3C-like protease inhibitor which inhibits viral replication, and ritonavir, a protease inhibitor with pharmacokinetic boosting effects. Certain patient criteria must be met prior to prescribing. As of July 6, 2022, the EUA was revised giving licensed pharmacists prescriptive authority for the agent.
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LEARNING OBJECTIVES
Upon completion of the chapter, the reader will be able to:
List common bacteria that cause acute otitis media (AOM), acute bacterial rhinosinusitis (ABRS), and acute pharyngitis.
Explain the pathophysiology of and risk factors for AOM, ABRS, and streptococcal pharyngitis.
Identify clinical signs and symptoms associated with AOM, ABRS, streptococcal pharyngitis, and the common cold.
List treatment goals for AOM, ABRS, streptococcal pharyngitis, and the common cold.
Develop a treatment plan for a patient with an upper respiratory tract infection (URI) based on patient-specific information.
Create a monitoring plan for a patient with a URI based on patient-specific information and the treatment regimen.
Formulate appropriate educational information for patients about URIs and proper antibiotic use.
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Upper respiratory tract infection (URI) is a comprehensive term for upper airway infections, including otitis media, sinusitis, pharyngitis, laryngitis, and the common cold. Over 1 billion URIs occur annually in the United States, triggering millions of antibiotic prescriptions each year, of which up to 50% are considered inappropriate for use for acute respiratory conditions.1 
Most URIs are caused by viruses, have nonspecific symptoms, and resolve spontaneously.2 Antibiotics are not effective for viral URIs, and their excessive use has contributed to resistance, which has prompted development of clinical guidelines ...